As I lay dying (don't let me lay alone)
by flowers-your-way
Summary: Sam's organs start to shut down one by one after the trials and, instead of being in a coma, he is aware and in agony. Dean is trying to be there for his brother but that means he must watch helplessly from the sidelines. Basically, the extreme Sam whump that season 9 never gave us. Inspired by a prompt on LJ's Oh Sam Birthday Fix-it Fest.
1. Pancreas

The first thing to go is his pancreas.

Dean cannot comprehend for the life of him why God would choose such a seemingly random organ to go out of commission. He also has yet to learn that this is just the beginning of a long road leading towards Sam's demise. The pancreas is just the first pit stop on the crippling journey.

The first thing to go is his pancreas and neither Dean nor Sam will know that until hours after bursting through the hospital front doors. But if there is one thing Dean knows for certain, it is that something is seriously wrong. Sam should be asleep instead of weakly withering on the bed looking like poster kid for some kind of charity. It has been six hours since they arrived at the hospital. Six hours since the poking and prodding began to dig up the truth of what had been done to Sam's body during the trials.

The results, of course, hadn't been pretty. Sam's body had been burnt from the inside and Dean had no fucking clue how you were supposed to fix that (_can't just slap some cream on it and call it day can you?). _With the potential organ damage, painkillers weren't a possibility until more was known about Sam's condition. Everyone, Dean included, had thought Sam would pass out from the pain. Dean suspected that some thought he would slip into a coma.

Yet, here they are. _Why oh why does my kid brother have to be so fucking stubborn? _Sam is laid on the bed nearly in the fetal position (not quite strong enough to get there) with his arms curled protectively around his stomach. His eyes are squeezed shut and his jaw clenched tightly. His hands grasp weakly at the bedding. Dean doesn't know how much longer he can watch his brother suffer like this.

"Sam," he says softly as he reaches out to pry his hand from the bed sheet and place it in his, "why don't we try those deep breathing exercises again?" For the life of him, Dean never thought he'd be suggesting deep breathing instead of whiskey or morphine for pain.

"Can't do it…" he stutters out quietly.

"Well we gotta try something Sammy. I'm gonna go see if I can track down Cas." Just as Dean is standing up to go, he feels Sam grab his hand more tightly than he should have been able to. He opens his eyes for the first time in at least an hour. They are glassy and full of raw emotion and Dean knows that he won't be able to refuse anything they ask of him. Sam manages enough strength to move his head side to side in a silent plea.

"Okay okay Sammy, I'm not going anywhere I promise."

Sam still grips him even tighter as if to tether himself. Neither man sleeps a wink.

Xxxxx

It isn't until the morning, after the nurses manage to pump through the IV the minimum nutrients required to keep a human alive, that Sam starts to act even odder.

"De, dizzy" he presses his palms into his eyes.

"This is new isn't it Sam? You've not felt dizzy since we brought you in."

He shakes his head and then feels the repercussions of his decision as he presses his palms harder into his eyes. "Sick"

For the first time since he got here, Dean feels a little less helpless. He grabs the trash bin as quickly as possible and has it under Sam's nose just as he leans towards the edge of the bed and starts to gag.

"Easy, easy." Dean rubs his brother's back and tries to forget about the fact that Sam is too weak to even sit up to throw up. He presses the call button instead.

Charlene pokes her head through the door and quickly assesses the situation. "Okay Sam, let's get you sitting up," she says as she rushes across the room to raise the bed. Dean pulls the trash can next to Sam's lap but cannot turn him from his side. Charlene grabs Sam's shoulder when he threatens to topple forward.

"He said he was dizzy after breakfast and now he's throwing up which, duh, is obvious," he rambles nervously, " He wasn't like this last night so I have no idea what's changed."

She frowns and looks at her patient who is somehow curled in on himself and puking his guts up at the same time. Not a good sign. "Sam, can you straighten out for me?"

He eyes her reluctantly and slowly moves to uncurl himself. It's evident to everyone in the room just how much pain Sam is in.

"Ok Sam, I'm going to need to feel around your abdomen. Tell me what hurts."

Dean doesn't know how much more of this he can handle watching. He hates that in order to relieve Sam's pain, they have to cause him more pain. He grabs his hand tightly and places his other in his shoulder. Sam's jaw is still clenched and his body is rigid. "Easy Sammy, try to relax a little." His tension only eases slightly.

Then Charlene starts to prod. Sam grimaces. "'s tender." She frowns and starts to press higher up the abdomen. That's when Sam lets out a stuttered breath. " 'urts" he grips Dean's hand tighter and tries to curl in on himself. The monitor indicates that his pulse is increasing rapidly.

Dean watches in confusion as she stands up from the bed. "What's wrong? Can we give him something?"

"I'm not sure but we are gonna go for some tests."

Xxxxx

It's when the test results finally return that they learn of the news of Sam's failing pancreas. It complicates things quite a bit, considering Sam will now have a hard time with digestion and is considered pre-diabetic. But at least, he finally gets some pain medicine.

The doctor is still in the room but Dean finds it hard to pay attention to her. If it wasn't for his brother suffering so quietly next to him, he would've asked her to leave already.

"His organs were showing signs of being burnt yesterday but the descent into failure was unexpected. Sam, have you had issues with alcohol in the past?"

Dean grimaces as he watches Sam's face turn red. He's seething. God, if one more person suspects Sam of being an addict, he's gonna lose it.

"No. He doesn't drink anymore than your average joe. Besides, he hasn't had a drink since he started getting sick."

Dr. Weismann can tell the tension is growing and places her hands out in a placating motion. "Ok then we have no way of knowing why his pancreas decided to head towards shutting down. He doesn't fit any of the risk factors. We will have to just treat it and hope that none of the other organs decide to follow suit. We will keep the pain medication and the anti-nausea. I'm still concerned that you somehow aren't sleeping so we can provide a light sedative and see how you do."

Dean watches as she grabs her clipboard and leaves the room. He hates how she says _hope, as _if hope has ever worked out for them. The Winchester's had never been good at sitting and hoping.

"Hope my ass…" he mutters, "I'm going to find Cas. Organs shutting down are serious business and I'm not screwing around waiting for these people to figure it out."

"Dean, stop". And leave it to Sam, his fucking pancreas is failing but it's the first time in the 18 hours they've been there that he's been able to construct a full sentence. "It's a mess out there. Cas is probably working on cleaning it up. We don't need him to worry about me. If he doesn't contact us soon, you can go look for him but don't go because you're worried about me."

Dean cannot believe what he's hearing.

Sam looks up at him with his eyebrows raised and a gleam in his eye, lips pursed. It's the same look he gets when he arguing case details. The one that screams at Dean that he's being unreasonable. Some might call it a bitch face , which Dean wouldn't dispute. But to Dean, it's always meant that Sam had his mind set. "This is it. It's just the pancreas, not my heart or lungs. People can live without these if they really have to. Dean, it's ok."

In a few days, Dean will look back on this moment and wish that Sam had his mind set on some other conclusion. He will wonder if either of them fully believed Sam in this moment and then he'll wish it was all just that simple. Because Sam had never been more wrong and Dean had never wanted to believe him more badly. A toxic combination.

Dean huffs, "Fine, ok. But if he doesn't call soon, we will have to figure this out."

"Good. Thanks."

Sam leans back in bed and starts to relax. Dean notices the same lines of pain on his forehead. His arms are still curled around his stomach, albeit more loosely. He notices the dark circles under his eyes and the slump in his posture. Sam is nowhere near as miserable as he was last night but now that Dean can see through the curtains of his pain, he can tell just how tired Sam is. Damn, he's tired too.

"Think you can sleep tonight little brother?"

Sam closes his eyes and lets out a slow breath, seemingly trying to control his emotions. This is how Dean knows he has to be tired. Sam can get emotional when he's tired and in pain. Also, clingy but not admittedly so until more drastic situations. Dean puts his hand on Sam's knee.

"God, I hope so."

"Me too. Although on second thought, maybe not. Your damn snoring will keep me up all night." Dean knows his attempt at humor is poor but he has to do something. He has always dealt with his pain through laughter. If he can get Sammy to laugh or even smile, he figures it'll be a win-win.

Sam looks up at him with watery eyes and bites his lip in the way that people do when they are afraid that any slight motion will break the fragile floodgates they have built to protect those around them from an onslaught of emotions. He looks down and swallows slightly and when he returns to his brother's, he is only slightly more put together. He cracks half a smile, "My snoring? At least, I don't talk in my sleep. I don't care how amazing you think Carmen or whatever her name is. Some things a brother should just never know."

"Ok, quite a few people would pay good money to hear about that encounter," he smiles and looks of in the distance, pretending to be lost in a memory just because he knows it will annoy Sam. That's what brothers are for, right? "Besides, the pain medicine plus the sedative they have you on will have you out like a light."

"Yeah…" Sam seems worried about something but Dean isn't sure what.

"Cmon, I can put on one of those shows that always puts you right to sleep and I'll get comfy right over here."

Sam nods his head and twenty minutes into Bonanza, he's asleep. Still, even in sleep and loaded with drugs, Dean can't help but think that he looks in pain. His forehead is wrinkled like a headache has followed him into his dreams. Dean had every intention of going to sleep as soon as Sam dozed off but now he can't find it in himself. He keeps two fingers on the pulse point on Sam's wrist, not quite trusting the machine, and wishes he could've found a different old western to put himself to sleep.

On the tiny hospital TV screen, Little Joe has found himself in another patch of trouble. See, Dean always saw Sam in Little Joe. Both always find themselves in troubling situations, whether by their own fault or unfortunate circumstance. Both have good hearts and lots of trust but little sense.

So Dean watches as Ben, Adam, and Hoss Cartwright ride up the mountain to save their son/brother from where he is being held at gunpoint because he tried to save a child who had run away. Dean always liked Bonanza because the Cartwright family was so close knit and they always managed to save Little Joe from the predicament of the week. They reminded him of the Winchesters, deceased mother and all.

That is, until now. Because Dean was damn well sure that in all his watching Little Joe's pancreas never shut down and he didn't nearly complete heavenly trials designed to kill the unfortunate soul who wanted to save the world. No, they didn't make those kinds of shows in the 60s. Little Joe always had his two brothers and his father to save him as well. Sam only had Dean and right about now, Dean wished there were at least two more of him so that they could have a conference to figure out what the hell to do.

But there was only him. And Sam. Both people very real and nonfictional, unlike the characters on the screen. Dean shakes his head to snap himself out of his daze and quickly grabs the remote and turns the TV off. He spares one more look at Sam who is sleeping as peacefully as possible given the circumstances. He feels his pulse one more time. He wants so badly to brush the hair from his eyes, maybe even give him a kiss on the forehead. However, if he were to wake Sam up, he'd never forgive himself so he refrains.

Instead, he leans back in his chair and decides to keep Sam's pulse under his fingers. He falls asleep to the steady thrumming of his brother's heart, telling himself that it'll still be there when he wakes up. Hoping that it will still be there when he wakes up.


	2. Liver

Dean startles awake with the soft touch of hand on his forearm. A strangled "Sammy" escapes his lips before he can stop himself. He had almost forgotten where he was but as soon as he is awake, he is reaching for the pulse point on Sam's wrist. The heart monitor _thump thumps _in the background and he feels his own heart rate recover. Dean searches Sam's face for any sign of awareness but only sees him sleeping fairly peacefully. His forehead is slightly scrunched, showing signs of pain even in sleep. Dean turns to address whoever woke him.

It's not Charlene that greets him, to Dean's dismay, but rather it is Dan. Not that Dean doesn't like Dan but after Charlene's discovery of Sam's failing pancreas, he found her the most trustworthy of all the nurses.

Dan speaks quietly but it still has Dean on edge. "A bed came open in ICU this morning and with Sam's condition, we've been ordered to transfer him."

Dean grimaces and looks down at the floor, shaking his head. Part of him hates that Sam is being moved. The ICU was always sadder, louder, and stricter in terms of visiting hours. Part of him is outraged that Sam wasn't placed there immediately.

"Yeah. About time."

"We are very sorry about that. Someone will be by to move him within the next half hour but we must inform you that visiting hours are only from 11am to 8pm so we will have to ask you to leave."

Dean doesn't believe that Dan sounds very sorry. Hell, he looks like he doesn't even want to be there. Dean wonders if Dan sees Sam as just a junkie or an addict with the needle marks on his arms and checked-out pancreas.

"You think I'm leaving him alone like this?" Dean growls.

"Well he won't be alone. I assure you our staff is-"

"I don't care how good your staff is. You know nothing about what is happening to him." Dean doesn't even notice he voice steadily rising.

"Mr. Wesson please…" Dan tries to placate the situation but Dean will have none of it.

Dean is seething but his anger melts when he hears a soft noise behind him. Sam is just waking up. His eyes are groggy with pain and sleepiness.

"Dean.." His hand searches for Dean as he becomes aware of his surroundings. Dean quickly forgets about Dan and turns to Sam.

"Hey Sammy. I'm right here."

"What's going on?"

Despite Dean's quick heated stare in his direction, Dan speaks up. "I was just informing your brother that you will be transferring to Intensive Care shortly."

Sam looks down at the mattress and studies it like it is suddenly the most interesting thing in the world. He swallows and looks back up at Dan.

"Thank you for letting me know."

Dan just nods curtly and leaves the room.

Dean wants to feel relieved that he is gone but he barely notices as his and Sam's eyes have stayed trained on one another. There is something indistinguishable in those eyes. He could swear that for a moment he sees fear and then pain cross through them but it's gone before he can decipher it. Now Sam's eyes are a mixture of sorts with the predominant ingredient being determination.

"It's alright Dean."

"I never said it wasn't," Dean shrugs innocently.

"I can see it written all over your face. I'm not happy about it but ya know…"

This is the moment when Dean can see the fear retake Sam's face. He hates it. He despises it. If he thought his brother only needed soup and bed rest, he would take him away from there right now.

"Well they're delusional if they think I'm going to leave you there."

"We don't have an option Dean. Please just go home and get some rest and a shower. You stink."

It's a poor attempt at a joke and they both know it but Dean manages a slight chuckle anyways. And Sam, despite his increasing agony, holds really still and tries not to flinch. When the nurses come to transfer him and Dean reluctantly leaves, he cannot decide if he is upset or relieved that his acting seemed convincing.

He would later realize that it was the former.

Xxxxxx

The thing about Sam without Dean and Dean without Sam is that, historically speaking, it has never gone well. The two move in sync in a way invisible to the naked eye. At least until things go to shit.

So when Sam rolls away toward ICU without Dean, he feels naked. They hook him up to the machines to monitor his vitals more closely and he forgets that they are off because of his failing pancreas, not because of his brother's absence.

Sam wonders why he suddenly feels such separation anxiety. He spent most of his life being considered the "independent" brother. But something about the trials made even the smallest events feel like a finale. He feels tears gather in his eyes and he is embarrassed for acting like such a baby. It's boring without Dean. Hell, it's scary. Anxiety and pain make it difficult for sleep to claim him.

But he turns on the TV anyways and tries to distract himself with the random nature documentary playing. He eventually feels his eyes slip closed.

Xxxxxx

When he wakes again, he is not quite sure which way is up and which way is down. Opening his eyes, he still feels disoriented. He tries to focus on one spot on the bed to reorient himself. His concentration is so intent that he doesn't even hear his name being called.

"..am Sam, Sam" one of the nurses (he can't recall her name right now) is touching his arm lightly. He comes back to reality and tries not to flinch too hard at the unfamiliar presence.

"Sam? Are you okay?" She asks with concern evident on her face. He clears his throat and tries his best to find the words to answer but his brain is failing him. "Let me see your hand honey. I'm gonna check your blood sugar."

He wants to acknowledge her but he can only lay still as he takes his finger and pricks it. "Looks a little low. I'll have a food cart come by in a few because we need to get something in you."

He's finally with it enough to nod but the last thing he wants is food. He's nauseous and dizzy and confused for some reason. He has no idea what time it is but he hopes Dean is coming back soon.

When the food comes, he can't bring himself to eat it.

Xxxxxx

Dean really meant to be back sooner but sleep forcefully overtook him as soon as he parked the car outside the trucker gas station down the road. He took the quickest shower possible and grabbed the quickest meal he could but he had already lost hours he could have been with Sam. He hates himself even more when he finds the rush hour traffic is overwhelming. The streets seem even more chaotic than usual. It's nearing 6 pm when he walks into Sam's hospital room and he can't believe he has been this stupid.

He kicks himself further when he looks at Sam. He looks even worse than he did this morning. There is an open pudding cup on the desk next to him and he is slightly curled in on himself. The pain lines on his face are pronounced. His eyes are moving rapidly under his eye lids. He shakes his shoulder slightly, "Sammy, Sammy. I'm back."

Sam stirs awake and it takes him a minute to locate him. "Hey little brother." Dean speaks softly and waits for Sam to find his eyes. But he doesn't. He grabs Dean's hand and grips it harder than should be possible given his current just stares at their hands like he doesn't know anything else. Dean's concern shots through the roof and his first instinct is to sit down on the bed next to Sam. He lightly brushes Sam's hair back from his face in hopes of catching his attention. "Sam, can you look at me?"

Sam's eyes dart up for one moment and then back down. "Dizzy. Ceiling is spinning." He swallows and refocuses on Dean seeming to curl even further into himself. Dean can't stand this. Sam is almost in as much pain as he was the night they brought him in and the hospital refused to give him painkillers. Now, even on the medication, he seemed to be getting worse instead of better.

"Your probably dizzy because you haven't eaten anything, college boy."

"Did eat."

"Yeah then explain why this pudding cup is still full?"

And Sam looks genuinely surprised. "Oh". Seriously, who is running this place? His brother didn't even know that he didn't eat the snack they brought him? And nobody thought that was an issue considering he's "pre-diabetic" or some shit?

"You know you have to eat. You can't mess around like this."

"Can't. Feel sick. Fell asleep."

"Ok let me get a nurse because clearly nobody is doing their job around here. See if we can get you some anti-nausea and some of the good stuff."

Xxxxxx

The nurse comes 15 minutes later which isn't quick enough for Dean's liking. He is about to rip them a new one but one look at Sam's face and he loses all focus.

"Can you bring him some more food please? He didn't eat the snack they brought in earlier."

"Of course. We will have something sent right over." And the nurse's sympathetic look has him almost ready to forget the fact that it took her 15 minutes to arrive. _Almost. _He watches her adjust Sam's IV bags, recording all that she's doing on her chart. Sam's breathing steadily and laying so still that he could pass as sleeping. But Dean knows better. His arm hasn't left the bottom of his rib cage and his head is turned slightly, eyes laser focused on the bed sheet next to his elbow. He doesn't acknowledge the nurse or Dean's presence. Dean thinks sadly that Sam just looks out of sorts, disoriented and dazed.

Dean looks up at the nurse and down at Sam one more time before he works up the nerve to ask the question, "Should he be this confused?" He feels so guilty talking about Sam like he isn't even in the room, but his brother doesn't seem to care.

"With all the damage his body is dealing with, it only seems natural that he might be incredibly fatigued. That can cause some confusion." She reassures him.

"It seems like more than just fatigue. Are you sure?" Dean bites his lip nervously.

"I assure you Mr. Wesson, we will be keeping a close eye on your brother tonight and we will let you know if anything changes. Oh and here's the food you asked for," she reaches for the jello cups sitting on the cart that just passed by in the hallway, " this is as much as we can give him tonight. You can stay and make sure he eats it but after that, visiting hours are up." She looks at him sternly and Dean glares back just as fiercely.

"Yes, ma'am. I understand." He tries to hold back the biting tone he wishes to unleash. She looks him one last before turning and exiting the room. Good, Dean can refocus his attention on what matters.

"Sammy" He waits for his brother to respond before reaching for his hand. Sam looks up from his blanket, almost bewildered. "Sammy," Dean reaches for his hand, "hey dude, you have to eat something." Sam scowls but Dean knows he can't back down. "Please, for me? Just a little bit?" His expression must be more pleading and worried than what he thought because Sam slowly nods his head.

"I'll try" He croaks. So Dean raises the bed and feels guilty when the shift causes his brother to wince noticeably. Dean grabs the jello and opens it. Sam holds his hands out, too proud to be feed by his big brother. Dean has to admit, it's painful watching Sam try to eat. His hands shake horribly and the sound of the metal spoon tapping the side of the container fills the room. It looks like it is taking the last bit of Sam's energy to just sit up. But Dean can't take this away from him. He can't offer his help. At least not when Sam looks so determined to do something on his own. Dean doesn't know if he is protecting himself or Sam but he knows that pulling away this last piece of independence will make their situation too real. He can't do it.

Sam gets through half the second jello cup before slowly lowering the spoon and turning to Dean. " I can't do anymore." He says it like he's disappointed but this is more than Dean expected in the first place.

"That's alright. That's good enough for today."

When Sam turns to look at Dean again, he looks so sad, so _fucking tired. _Dean's heart breaks for the 50th time that day.

"Why don't we get some sleep, eh?" He lowers Sam's bed. "They are kicking me out but I'll stay till you fall asleep and I'll be back first thing in the morning." Sam only nods shakily, reaching out his hand for Dean's. He grabs it and brushes Sam's hair as he tells him old stories from their childhood, hoping the noise is monotonous enough to be soothing.

Sam falls asleep and Dean wipes away his tears before they can even threaten to fall. He doesn't know how but he forces one foot to step in front of the other until he's out of the hospital and into the impala.

Xxxxxx

Sam doesn't sleep easy that night. He forgets where he is every time he wakes up. When he closes his eyes, hellfire flashes behind them. The hallucinations have been gone for over a year but it feels like Lucifer is fresh in his ear. He's carving up his stomach. He's pulling on his insides. It's like he never left.

Dean is never next to him when he wakes up.

Xxxxxx

"_Are we having fun yet, Sammy boy?" Lucifer grins menacingly over Sam as he lays on the floor. "If not, that's okay. We have all the time in the world."_

_Sam has hatred in his eyes and fire in his fight. He knows he can't say or do anything to make it stop but he won't give Lucifer the satisfaction of playing along._

"_You know," Lucifer sharpens his knife, " I was there when God wove the first human together. I know anatomy better than any scholar. I could teach you some if you'd like college boy." _

_Lucifer makes three delicate cuts on his stomach in the shape of a star. "I could show you all of your insides," His snake tongue tickles Sam's ears as he lowers his voice to a whisper, "I can be a part of your insides. In 100 years, I can show you every part of your insides. And then eternity will only be beginning because there is no end."_

_He plunges his hand straight into the intersection of the cuts._

_Sam screams and screams_

And screams. Hands are all over him. There is shouting and harsh yelling. Something high pitched screams in the background.

Hands again. Trying to grab him. Pull him under. Rip him apart. He can't take it. He shoves at the hands in a desperate attempt to get away.

_It's a cage. Where will you go?_

He doesn't know but he cannot have these hands touching him. He curls around his stomach and tries to block out the animalistic noise he keeps hearing. Someone is screaming and it's so loud. He hopes it isn't Adam.

*radio static* _Yeah he's violent. Get someone in here. We need to do a reading. Somethings wrong._

What the hell are they saying? And why won't these hands stop touching? He suddenly feels strong arms push him down. They grab his arms and pull them away from his stomach. He hears the clink of metal on metal and he can't move his hands anymore. His stomach is opened. He's exposed. He feels sick as he draws his knees toward his chest to try to cover up. As soon as a hand touches one, he's kicking. And then the strong arms are pulling down on his shins. He finds himself unable to move them.

When his vision comes back, he doesn't see Lucifer. He doesn't see Dean. He sees two large men and three women in blue outfits. He doesn't know who they are or what they want from him. They are probably just another one of Lucifer's tricks. He can't fight anymore but he looks at them with tear filled eyes and whispers _please._

_Please please please Dean?_

_Xxxxxx_

Its 8 am when Dean gets the call. His heart drops into his feet.

"Mr. Wesson, we would like for you to come in early today. Your brother has become violent overnight and we need to discuss our next steps for our plan of action."

Yeah, no. Dean knows how this shit works. They are not sending Sam to the psych ward. No way.

When he gets there, it's even worse than he thought. Sam is lying on the bed, arms and legs tied up. _No no no no. _They have no idea what they've done. As soon as nurse Jackie walks in, he loses his shit.

"Ah Mr. Wesson. You got here sooner than expected. Sorry I wasn't able to meet you at the door to warn you about all this."

"All this? What the fuck is this?" He struggles to contain his anger and keep his voice at an acceptable hospital volume.

"These are the actions that had to be taken to ensure the safety of our hospital staff." She looks at him calmly.

"Look lady, I don't care what you thought you had to do but this is absolutely the last thing that should have been done.

"I'm sorry Mr. Wesson but it's hospital policy…"

Ok. He's had enough of this bullshit. "Fuck your hospital policy! That's my brother and I know what's best for him. You cannot tie a man down like that. Not one with a past like Sam's."

"Sir if you could just calm down and explore the situation.."

Dean thinks steam might be coming out of his ears. He hates talking about Sam like he isn't in the room. He hates telling this nurse what Sam won't even admit to himself. "He has PTSD! He can't. Being tied down? That's a trigger. I won't have him re-live what he went through."

The nurse looks shocked but not quite sorry. " That was not indicated in our files. Perhaps they would be better equipped to handle him in the psych ward…"

"And perhaps he would be much better off if he weren't here in this hospital, all by himself. I'm the only one I trust to look after him. You've done enough." He looks at her pleadingly but with the threat still in his eyes, "please just leave us alone and send someone in here to undo the cuffs before I break them myself."

She nods and leaves. It's finally just him and Sam. Poor sleeping Sam who is getting more and more restless in his sleep. Dean doesn't know where the worst nightmare lies for Sam. Is it even worth it to try to wake him if _this _is what he wakes up to?

He doesn't have time to ponder before Sam is deciding for him by waking up on his own. And there it is. The confusion. He moves his hand slightly and feels the restraint. Dean watches in horror as Sam's gaze starts to shift to his hand.

"Hey, hey Sam look at me" He reaches out to gently touch his cheek, to steer his eyes away from what will hurt him. And Sam finds his eyes and stares at him for a second. Dean can see it. The panic is building. Sam is slipping away from him, his breathing getting heavier. "Hey it's alright dude" Dean lies.

Sam isn't having it. "Why…" He looks at his hand and pulls again. His breathing is getting heavier. "I can't.."

It's at that moment that the nurse returns. Sam's panic is even more palpable as she comes in. He has no idea who she is and Dean knows that when Sam gets like this, he can't have anyone else around.

She tries to keep a calm demeanor, "Mr. Wesson I'd like to remove those if you'll just stay calm" and she moves towards the bed.

"Lady I wouldn't do that if I were you" Dean can't stand the fear radiating off his brother, "Just give me the keys."

"Sir, we can't release him if he is gonna be a risk to himself or those around him."

This lady is getting on Dean's last nerve. None of these people have a clue what to do with Sam. "He won't be. He just can't handle strangers right now. He will trust me."

"Sir that's against hospital policy."

"Fuck the policy, the only way to make this situation go away is to let me let him out."

Damn this lady is persistent. Dean is cutting her with his worst stare and she is still holding her ground. Fuck.

"Look I can sedate him…"

And as soon as Sam hears _sedate _his head pops up, "No… no… no!" Sam starts tugging and pulling his limbs while his eyes dart frantically around the room. Dean hopes he is looking for him.

"Hey Sammy! Sammy! It's alright. It's ok. Look at me little brother." And when Sam still can't find him, he chances grabbing for his hand and pushing on the still present scar. "Hey hey it's ok I'm here. You're here. Stone number 1. It's ok" He repeats it like a mantra.

"Dean…" His panic mixes with sadness, "help"

The tears streaming down his face is where Dean draws the line. He turns to the nurse. "Give me the key and then get out. I wanna talk to the doctor, or a manager. I don't care. I won't stand for this," He sighs and softens his expression, "please I know how to take care of my brother."

She shakes her head in slight frustration but Dean can see the pity forming in her eyes. He hates it but it makes her more human. More empathetic. That's what he needs. He needs at least one person to give them a break.

She hands him the keys and he opens the locks as she retreats wordlessly. Sam's breathing is still heavy, still choking on sobs. He flings himself to the side of the bed with more strength than he should be capable of in his state. Dean thinks he's going in for a hug but quickly steps back and grabs the bed pan when he realizes that's not the case. He has the pan under Sam just in time for the heaving to start. Awful retching noises seem to echo off the walls. Dean tries to hold the pan, Sam's hair, and himself together all at the same time. When Sam is done, his body goes limp and Dean has a hold of his brother before he has the chance to sink into the bed. He brings himself to sit on the bed and cradles his brother waiting on the doctors return.

Xxxxx

Dean hadn't realized he had fallen asleep with Sam's head tucked into the crock of his neck. So he startled awake when Dr. Weismann finally returns.

"Hello Mr. Wesson. I've been informed that you are not happy with the care your brother is receiving here."

"Not happy is an understatement," Dean scoffs, " I'm fully prepared to sign my brother out of here if something doesn't change."

"What exactly would you want to change?" She asks with a curious glance in his direction.

"For starters, this whole visiting hours is a load of bull. Your staff don't know how to take care of him and when I'm not here, he panics."

"That's entirely against policy. I don't think I can do that."

"Fine then bring us the papers to check out. I won't stay in a place that can't give my brother what he needs because of some fucking policy. Nobody could calm him down earlier except me and I'm not gonna have him go through that again."

Dean glares at her with a look sharp enough to kill and she just looks back, thinking. A damn staring contest. She taps the pen on the clipboard and bites her lip like she's at war with herself.

"Ok fine. I'm not really supposed to do this but you have a good point. I'll try to get you cleared to stay here."

Dean huffs out a breath with a genuine look of relief, "Thank you"

"Ok let me check on Sam now because I am also here to do rounds."

She frowns as she looks at charts and even more noticeably when she actually looks at Sam. She gently grabs his arm and pulls it closer to her. Dean can't tell what she's looking at but he feels dread wash over him. He smooths Sam's hair and holds him a little tighter. It's when he brushes Sam's hair behind his ear and really looks at his neck that he notices it.

Sam is the slightest bit yellow.

"We are going to need to run some tests," Dr. Weismann says quietly. And Dean just nods because he doesn't trust himself to speak.

Xxxxx

The results come back later the same afternoon. Acute liver failure. It's like a sucker punch. Dean can't breathe. First Sam's pancreas and now his liver? His kid can't catch a break. Dean grabs Sam's hand and reveals in the fact that he's still asleep. Dean can break the news to him when he wakes. Sam doesn't have to know about his failing liver for now. He also doesn't have to know about the tears streaming down Dean's face as he holds onto his little brother's limp hand like a lifeline.

The nurse rolls in a sofa bed but Dean can't leave his brothers side.

And now, he doesn't have to go anywhere.


End file.
